Active NPI
Colleen R Bowman
- Massage Therapist
- Madison, WI
National Provider Identifier
1194484972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 11938-146
- Practice address
- 4602 Eastpark Blvd
Madison, WI 53718-2002 - Phone
- (608) 262-9355
- NPI assigned
- Dec 9, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 11938-146 | WI | Primary |
Addresses
Primary practice location
4602 Eastpark Blvd
Madison, WI 53718-2002
Mailing address
4602 Eastpark Blvd
Madison, WI 53718-2002
Phone (608) 262-9355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11938-146 | WI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639008000000",
"number": "1194484972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4602 EASTPARK BLVD",
"city": "MADISON",
"state": "WI",
"postal_code": "537182002",
"telephone_number": "608-262-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4602 EASTPARK BLVD",
"city": "MADISON",
"state": "WI",
"postal_code": "537182002",
"telephone_number": "608-262-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWMAN",
"first_name": "COLLEEN",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-12-09",
"last_updated": "2021-12-09",
"certification_date": "2021-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "WI",
"license": "11938-146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.